Clinical Effect Analysis of Posterior Internal Fixation and Fusion for Thoracolumbar Vertebral Fracture

2021 ◽  
Keyword(s):  
Vertebral Fracture ◽  
Internal Fixation ◽  
Clinical Effect ◽  
Effect Analysis ◽  
Thoracolumbar Vertebral Fracture

Epidemiological and Clinical Studies in Cats with Thoracolumbar Vertebral Fracture and Luxation and Its Management

2020 ◽  
Author(s):  
I. Nath ◽  
S. Dhanalakshmi ◽  
M. R. Das ◽  
S. K. Panda ◽  
A. K. Kundu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Vertebral Fracture ◽  
Conservative Treatment ◽  
Clinical Outcome ◽  
Epidemiological Data ◽  
Neurological Dysfunction ◽  
Grade 3 ◽  
Time Of Presentation ◽  
Thoracolumbar Vertebral Fracture

Background: Thoraco-lumbar spinal trauma frequently results in neurological dysfunction of varying degrees in domestic cats. The consequences may be permanent disability or death depending on severity and segment of spinal cord affected. Assessment of primary damage to spinal cord is important to prevent secondary damage and complications arising from neurological deficit. Since assessment of neurological dysfunction and its treatment in spinal trauma in cats is an evolving field, the present study was undertaken with an objective to record and associate epidemiological data and clinical examination findings at the time of presentation with clinical outcome on 60th post-treatment day in cats with thoracolumbar vertebral fracture and luxation, for a better clinical approach in this condition. Methods: 24 affected cats were assessed epidemiologically and clinically at the time of presentation. All the cats were treated either conservatively or surgically based on extent of neurological dysfunction and severity of injury on radiographic evaluation. Post-treatment observations was then correlated with epidemiological data and clinical findings to assess the clinical outcome. Result: In the present study, sub-adult semi-domicile cats were most affected and major cause was automobile accident. Presence of concomitant injuries (30%) affected recovery. Thoracolumbar spinal cord segment (T3-L3) was most affected (71%). Among 16 cats with unstable vertebral fractures, 5/6 cats recovered after surgical treatment and 2/10 cats recovered after conservative treatment. Survival and recovery was poor when degree vertebral canal displacement was more than 70% (10 cats). All 7 cats with grade 1 or grade 2 and one cat with grade 3 neurological dysfunction recovered after conservative treatment. 5 cats with grade 3 and 2 cats with grade 4 neurological dysfunction recovered after surgical treatment. Selection of surgical treatment provided better recovery in cats with unstable vertebral fractures and greater degree of neurological dysfunction.

scholarly journals Clinical effect analysis and radiographic outcomes of Isobar TTL system for two-segmental lumbar degenerative disease: a retrospective study

2019 ◽  
Author(s):  
zhisheng ji ◽  
Zhi-Sheng Ji ◽  
Hua Yang ◽  
Yu-Hao Yang ◽  
Shao-Jin Li ◽  
...  
Keyword(s):  
Clinical Effect ◽  
Degenerative Disease ◽  
Adjacent Segment ◽  
Intervertebral Space ◽  
Lumbar Degenerative Disease ◽  
Effect Analysis ◽  
Radiographic Outcomes ◽  
Adjacent Segments ◽  
Rigid Group

Abstract Background: Non-fusion fixation is an effective way to treat lumbar degeneration. The present study evaluated the clinical effect analysis and radiographic outcomes of Isobar TTL system for two-segmental lumbar degenerative disease. Method: Forty-one patients with two-segmental lumbar degenerative disease who underwent surgical treatment by Isobar TTL dynamic stabilization system (n=20) and rigid system (n=21) from January 2013 to June 2017. The mean follow-up period was 23.6 (range 15–37) months. Clinical outcomes were evaluated by oswestry dysfunction index (ODI), visual analogue score (VAS) and modified Macnab. Radiographic evaluations included the height of intervertebral space and range of motion (ROM) of the operative segments and proximal adjacent segment. The intervertebral disc signal change was classified by the modified Pfirrmann grade and University of California at Los Angeles (UCLA) system. Results: The clinical outcomes including the ODI and VAS were significantly improved in two groups after operation, but the difference between two groups was not significant. In addition, the clinical efficacy of modified Macnab in two groups was similar too. Radiologic outcomes include height of intervertebral space, lumbar mobility and intervertebral disc signal. The height of intervertebral space of upper adjacent segments of L2/3 in the rigid group were significantly lower than those in the Isobar TTL group at the last follow-up. Furthermore, the number of fixed segment ROM of L3/4 in Isobar TTL group was significantly lower than pre-operation, suggesting that fixed segment ROMs in Isobar TTL group were limited. And, the ROM of upper adjacent segments of L2/3 in the last follow-up of rigid group increased significantly, while the ROM of L2/3 in Isobar TTL group haven’t changed after operation. At last, the incidence of adjacent segment degeneration was significantly greater in the rigid group than the Isobar TTL group according to modified Pfirrmann grading system and the UCLA system. Conclusion: Isobar TTL system could get a good clinical effect for treatment of two-segmental lumbar degenerative disease. Compared with rigid fixation, Isobar TTL system can get better radiographic outcomes and maintain the mobility of the stabilized segments with less influence on the proximal adjacent segment.

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